State Allowing Memorial Hospital to Close Had Major Adverse Impact on Healthcare in RI, Says Report

State Allowing Memorial Hospital to Close Had Major Adverse Impact on Healthcare in RI, Says Report

Care New England’s decision to close Memorial Hospital has had an adverse impact on care, decreased access to healthcare and sent patients out of state for care, according to a new report.

The report commissioned as part of the 2018 closure of Pawtucket’s Memorial Hospital finds that the Rhode Island healthcare system was significantly disrupted and the access to care for those in the Blackstone Valley most impacted were those with language barriers, emergency needs, mental health issues, and drug overdose emergencies. 

The 285-page report was conducted by John Snow, Inc. -- a global healthcare research company.

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Care New England claimed in November of 2017 when it announced the decision to close the hospital claimed, “Today’s submission to the Department of Health represents a required and critically important step in the process Care New England carefully outlined recently. While we move forward with this difficult, yet necessary decision, we do so with compassion for those affected and the utmost respect for the legacy of care and community that Memorial has stood for throughout its history, while striving to ensure access to care throughout the service area,” according to James E. Fanale, MD, EVP, chief operating officer and chief clinical officer.

Following the closure of the hospital, CNE said it intended to provide certain community-based primary and specialty care services in Pawtucket. 

Union officials warned of the impact, “This is a blatant and irresponsible attempt by Care New England to sidestep the reverse certificate of need process and begin shuttering Memorial Hospital before state regulators have authorized any such measures," said UNAP at the time of closure. 

The consultant found that the closure of MHRI "removed a 'nucleus' of health care services for communities with high healthcare need. Although inpatient utilization had declined over the years, residents continued to use emergency services, hospital outpatient services, and ancillary services located on the MHRI campus."

And, "The closure of MHRI emergency department reduced access to primary care services for the service area population and demonstrated the need for enhanced primary care within the service area."

Further, the study found that "The closure of MHRI Emergency Department reduced access to emergency mental health and substance use services for service area population.

 

Emergency Room Access Severely Impacted

“An immediate system-wide impact after closure was the increased wait time and emergency department volume at area hospitals, in particular The Miriam Hospital. Several key informants and focus group participants noted noticeably longer wait times for emergency department services. Access to emergency care was hindered, not only from higher volume but also from the greater needs of population that had been served by MHRI Emergency Department (ED), i.e., those with more complex social needs, language barriers, etc. These factors contributed to the longer time needed to treat a patient within the emergency department," found the report.

 

According to the report:

- Target area population is forgoing emergency services when needed. Several key informants talked about the over-crowding in The Miriam Hospital’s emergency department and hearing about individuals leaving the ED without receiving services. Focus group participants talked about individuals not wanting to be transported to Kent Hospital for care because they would have difficulty getting back home given the distance and family/friend not having transportation.

- Target area population is going out of state for non-emergent services. According to data provided through a key informant interview, Sturdy Memorial Hospital (Attleboro, MA) saw a greater number of patients from Rhode Island in their recently opened urgent care center, following the closure of MHRI.

- Target area population is using the walk-in clinic instead of the ED for services - As a condition of closure CNE opened a Walk-in Clinic (aka Express Care) within Family Care Center/Internal Medicine Clinic facility that provides same day appointments for patients needing immediate, but not urgent/emergent care. The Walk-in Clinic provides extended hours but does not provide serve segments of the population (i.e. – patients with severe mental health challenges or women of child-bearing age).  Patients that arrive at the Walk-in Clinic requiring a higher level of care are transported to an emergency department at the nearest inpatient facility.